Bilateral TKR Indigo_bunting’s BTKR recovery

[Susie-Q]

standing at the sink and by the end I was *wiped out.*

Do you have an extra bar stool? Bring it into the bathroom and use that to sit on while drying hair, curling, etc. I did this with both knees. I found I'd get all wiped out trying to stand and dry my hair and that's only with ONE knee! In fact, we still have the bar stool in the bathroom and it's become a place to put my clothes while I shower.

Could this also be the reason I have some new pains deep in the joint - the last throes of healing bones?

Could be? I just think about this every time I read someone saying why are they hurting still at 8, 9, 10 weeks post-op when they think they should be all healed up.

 

[Indigo_Bunting]

@Susieqr clever! I actually shuffled off with wet hair but will keep this in mind.

 

[Ghostpipe]

You are doing really well! I couldn’t face a hair wash with my longish, thick hair. Ignored it until I could stand it no longer, then went to the hairdresser just before my three week follow up appointment.

Also, those two four hour sleeps! That’s some achievement.

 

[Indigo_Bunting]

With just a few dilaudid left I called the surgeon’s office to ask about anti-inflammatories to help with the next phase.The nurse said she would put in a request for celebrex but cautioned that insurance typically won’t approve it. She also offered a small refill of dilaudid.

Any wonder there’s a massive opioid crisis in the US when insurance companies will more readily authorize opioids than non-narcotic anti-inflammatories?

 

[Indigo_Bunting]

Just storing this here

Reference chart for knee flexion following total knee arthroplasty: a novel tool for monitoring postoperative recovery - BMC Musculoskeletal Disorders

Background Clinicians and patients lack an evidence-based framework by which to judge individual-level recovery following total knee arthroplasty (TKA) surgery, thus impeding personalized treatment approaches for this elective surgery. Our study aimed to develop and validate a reference chart...

bmcmusculoskeletdisord.biomedcentral.com

 

[Indigo_Bunting]

Day 10
- distinct downward shift in pain/sensitivity. I’m a lot more comfortable now.
- up to 3 sessions on the lounge doctor. Fell asleep on it
- PT session. I declined to do the squats. My flexion is 52 on the L and 58 on the R. Still lower than the day I left the hospital. Postop appt is next week (day 14) and PR hinted ominously that they would want my ROM much better, fast. I thought “or what?” but kept it to myself.
- I am happy to address the inflammation behind low ROM with an anti-inflammatory. My request is pending insurance approval.

 

[Booger]

Hang tough Indigo. It gets better. At day 10 thats still early. I know when my swelling started going down thats when i started feeling better and actually noticed the improvement. I did my exercises at home for the most part and went to all of my pt appointments but ther were good and bad days with some awfull ones thrown in for the hell of it.

Booger

 

[Taoquest]

What the…? 10 days out and they’re having you do squats?
Only pain and swelling can come from that. When I quit PT, my swelling went down and my ROM increased, all on its own. You can’t bend a swollen knee! For me, daily activities and walking heel to toe was enough, until I was ready to increase my activities.
I’m glad the Lounge Doctor is working for you. Sleep is good.

 

[Indigo_Bunting]

Day 12
- Spent the last two days with a focus on elevating to get the swelling down. The lounge doctor is more comfortable flipped over so the ridge doesn’t jab me in the back of the knee.
- some internal stitches making their way out. Per a forum search I am just putting peroxide on these. I’ll ask at post op on Tuesday (day 14).
- more time on my feet, more ADLs. Unvented a standing heel slide: lift knee and let the calf relax down, switch

 

[Indigo_Bunting]

Day 14. Two-week post-op appointment!

This was my first time outside in 10 days, since leaving the hospital. The brick sidewalk in front of my building is not walker friendly! First stop was radiology. A very kind tech did everything he could to get sunrise images (the knee bent kind) and succeeded only on one side. My knees don’t bend enough yet.

Then on to steri-strip removal (and getting the spitty stitches trimmed). My incisions look good. My x-rays look like they should. Discovered that my patellas were not replaced but that they have implants on the business side.

PA pleased with my ability to kick up with a straight leg. Agreed that lack of bend is likely from swelling, and that I do have moderate swelling. Encouraged use of celebrex for that and if my insurance won’t approve it, he would prescribe meloxican once I’m off lovenox. He encouraged me to use pain meds appropriately and said it is realistic to expect it to take 6-8 weeks to get off them. This was a relief to me since some of my handouts said all patients are expected to be off pain meds in 10 days!

He said that where someone has low ROM but not too much pain generally (that’s me) they might consider timing the pain meds around PT to push further (I can hear some of you rolling your eyes). He said the OS likes a certain number, I think it was 120, at one month….not something I intend to stress over.

Got the name of the PT I’ll work with outpatient starting at 4 weeks. Great news there - she helped me with something before and is hands down the best PT I’ve ever worked with. I was hoping she would still be there!

Pretty sore from the car and the effort to get the sunrise X-rays so just resting, icing and laying low for now.

 

[newlybionic]

Most OS are happy with 90 degree flexion at 1 month. You're right not to worry about the numbers. Concentrate on getting swelling down with elevation and icing as much as you can.

 

[benne68]

He said the OS likes a certain number, I think it was 120, at one month

@Indigo_Bunting Definitely don't worry about the numbers. I'm more than two months out, and still haven't reached 120.

 

[Sks1997]

Indigo, I can’t get over that they expect all patients off pain meds in 10 days. What a lack of understanding about recovery and how each person’s recovery is different. Unbelievable as I am 3 months out and still taking 1-2 pain pills a day.
And don’t worry about the flexion numbers. I have figured out that a person can have good flexion and still have all kinds of random and terrible pain for weeks to months. First time around, I made the mistake of thinking that my pain was because of my poor flexion. Didn’t have a lot of swelling. So I have decent flexion on this one but have dealt with lots of pain and problems with proper gait. It is what it is and each day is an adventure.

 

[Jockette]

Discovered that my patellas were not replaced but that they have implants on the business side.

Patellas being “ replaced” is a misconception, and I wish surgeons wouldn’t use that term. My surgeon said he was replacing mine, and I still have it, so I was confused after surgery.

Since joining Bonesmart, I have learned that there is no implant for a patella, there wouldn’t be anything to attach it to, therefore, it can’t be “replaced.” Like you said, what you have is a plastic button on your patella, which many of us have.

 

[Indigo_Bunting]

Day 16
- The smaller supporting muscles in my legs are waking up and contributing to walking. The big ones are super-sore and crampy and need the help! Terrible cramps in my calves. I am eating bananas.
- Thanks to improved stability I took a shower standing up! The stool was still in there with me so I could put a hand on it for support.
- Still visible bruising and swelling right around the knee.

 

[Ghostpipe]

That’s some going. With my bilateral, I was stable enough to walk round the garden with no aids at 7 days, but no way could I stand still long enough to stand up in the shower. I even paced up and down the bedroom whilst brushing my teeth, for months!

 

[Indigo_Bunting]

I even paced up and down the bedroom whilst brushing my teeth, for months!

Ha, I know all about that pacing. It’s what I do while steeping tea. What really feels like improvement to me is being able to stand still without relying on locked-out knees and increasingly angry IT bands. Getting those smaller muscles to do their part so it doesn’t feel like torture.

 

[Ghostpipe]

It must be nature’s way of getting you fit again. You can’t sit with your legs down nor stand still, so it’s either sleep or keep on walking!

 

[Scaredycat10]

I even paced up and down the bedroom whilst brushing my teeth, for months!

Ha, I know all about that pacing. It’s what I do while steeping tea. What really feels like improvement to me is being able to stand still without relying on locked-out knees and increasingly angry IT bands. Getting those smaller muscles to do their part so it doesn’t feel like torture.

I have had physio [her elbow] on my left IT band for months pre op as it played up every now and then due to uneven walking.
It's still a bit tight so I had the dubious privilege of her elbow again yesterday. Oh boy, did it hurt but equally, the difference after the elbow treatment is amazing. I am doing my best to keep up the IT stretches but the only one which doesn't really involve the knee so much is the side lying leg lift one, which I do on the bed.
I couldn't attempt that two weeks ago, but I can now.
I've added it to my home exercise regime.

 

[kneeper]

Day 14. Two-week post-op appointment!


He said that where someone has low ROM but not too much pain generally (that’s me) they might consider timing the pain meds around PT to push further (I can hear some of you rolling your eyes). He said the OS likes a certain number, I think it was 120, at one month….not something I intend to stress over.

If I had a nickel for every time a PT said "doctor wants x ROM" and then the patient goes in and OS says "doing fine." (my experience for sure). I don't think it's a problem to have pain meds on board when you go to PT *if* that happens to be how it times out. But like you know, taking pain meds *in order to do PT* would be a